Depression Among the Elderly, Teens and Kids

School Nutrition’s March 2014 issue explores mental health and mental illness with the aim of starting a conversation about these conditions, which often go undiscussed. While we’re often searching for signs of depression in spouses, friends and even coworkers, depression among children, teens and the elderly is often overlooked—and in many cases, signs of depression manifest differently than in most adults. School Nutrition offers the following overview to help continue to raise your awareness.

Depression in Children
Although depression in children is rare—it affects about 2.5% of kids, more frequently boys—it’s often undiagnosed and untreated, because symptoms wind up being lumped in with other emotional and psychological changes associated with going through the various stages of youth. The truth is that half of all lifetime cases of mental illness begin by age 14.

Some symptoms of childhood depression are similar to an adult’s, including feelings of sadness or hopelessness, changes in appetite and sleep, difficulty concentrating, fatigue and social withdrawal. However, the National Alliance of Mental Illness says that grade-school kids tend to complain of aches and pains instead, rather than articulate their emotional state of mind as depression or sadness.

Many children who suffer from depression also will experience anxiety. In fact, some experts point to anxiety—whether social anxiety, separation anxiety or generalized anxiety disorder—as the underlying issue for depressive symptoms. No matter the specific disorder, parents, educators and, yes, even school nutrition professionals should recognize when a child might need help. Although suicide in children is extremely rare, it does occur. Treatment for childhood depression can range from counseling to medication; currently, fluoxetine—commonly known as Prozac—is the only FDA-approved medication for depression in children.

Depression in Teens
Everyone has known an angst-ridden teen at some point, but when does that behavior slip beyond normal teenage drama into the realm of clinical depression? As many as 1 in 5 teenagers suffer from depression, according to Mental Health America, and every year, nearly 5,000 young people from age 15 to 24 commit suicide, making it the third-leading cause of death in adolescents.

Like children, teens also might complain of physical pains when they’re depressed, but an exam likely will fail to turn up any physical cause for the pain. Additionally, teens are less likely to experience predominant feelings of sadness when depressed, but rather express their feelings in irritability, hostility, anger or ambivalence. Additional symptoms that tend to be more prevalent among teens include withdrawal from parents, siblings and long-time friends, hanging out with a different social crowd, experiencing problems at school—particularly in a previously good student—running away (or talking about it), using drugs or alcohol, excessive Internet use or reckless behavior, such as aggressive driving or unsafe sex.

With teenagers, there’s a greater chance that depression could lead to suicidal thoughts; if you see any indication of this, alert a medical professional, school authority (if the child is not in your direct care) or call the National Suicide Prevention Lifeline at 1-800-273-TALK. Signs of potential suicide plans in teenagers include saying goodbye to friends and family, giving possessions to others, talking or writing about death or suicide, engaging in increasingly risky behaviors and withdrawing or seeming to undergo a radical personality change.

Depression in the Elderly
The trouble with identifying depression in the elderly is that it can be masked by a variety of other health conditions and life situations, such as dementia or grief. However, the Centers for Disease Control and Prevention reports that the majority of older adults actually aren’t depressed—estimates range from about 1% to 5% of older adults who live on their own. That number rises to 13.5% to those who require home health care and 11.5% for those in the hospital.

Like children, older adults who suffer from depression might not exhibit any of the common signs, but instead complain of low motivation, a lack of energy and/or physical ailments, including arthritis pain or headaches. Other clues include increased anxiety, memory problems, irritability, withdrawal from social activities, skipping meals and neglecting personal hygiene.

It’s tricky to distinguish between depression and dementia, but there are a few key differences. When it’s dementia, your loved one’s mental decline will happen slowly; the individual often becomes confused or disoriented and has trouble with short-term memory. When it’s depression, though, the mental decline often seems more rapid, especially with difficulty in concentrating—but the individual can correctly identify the current time, date and place. For those suffering from typical stages of grief, feelings of sadness will be intermittent, alongside periods of happiness or normalcy; with depression, however, that’s not typically the case.

The elderly are at particular risk of neglecting to recognize depression as a real medical concern, especially as many of them were raised in a period when depression and other mental/mood disorders—and their treatments—carried even greater stigma. Seniors also are concerned about becoming a burden upon their families. If you suspect depression in someone in their golden years, simply make sure she or he knows that you’re there to help, both as someone to listen and to support them in treatment.

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